Advances in medical education and practice · 2026
Professional Ethics Education and Moral Sensitivity in Public Health Students: A Pilot Quasi-Experimental Study.
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Masoudi Reza, Rabiei Leili
Аннотация
BACKGROUND: Public health professionals frequently encounter complex ethical dilemmas, yet dedicated ethics courses are often absent from curricula. This pilot study aimed to explore potential associations between a structured professional ethics course and self-reported moral sensitivity in undergraduate public health students using a controlled but non-randomized design. Given the exploratory nature of this study, all findings should be interpreted as hypothesis-generating rather than conclusive.
METHODS: A quasi-experimental, non-equivalent control group design was conducted with 53 undergraduate public health students (intervention group=25, control group=28). The intervention group participated in a 16-hour active-learning-based professional ethics course; the control group followed the standard curriculum. Moral sensitivity was measured using a newly developed questionnaire with established content and face validity but without confirmed construct validity at three time points. Data were analyzed using linear mixed-effects models with bootstrap sensitivity analyses. Given the design limitations, no causal claims are inferred.
RESULTS: No statistically significant baseline differences were detected between groups (P > 0.05). Following the intervention, the intervention group showed suggestive evidence of higher self-reported moral sensitivity scores compared to controls (group × time interaction: F (2102) = 15.4, P < 0.001). Effect sizes were medium to large (d = 0.71-1.71, with wide confidence intervals). The control group's scores remained largely unchanged over time.
CONCLUSION: This pilot study provides preliminary, hypothesis-generating evidence that an active-learning-based ethics course may be associated with higher scores on a researcher-developed measure of self-reported moral sensitivity in public health students. However, due to methodological limitations (non-randomization, one intact class per condition, small non-diverse sample, unvalidated instrument), no causal claims can be made and the findings should not be interpreted as evidence of improved ethical competence. Future randomized controlled trials with validated instruments are warranted before any curriculum modifications are considered. Given the pilot nature of this work, all results should be interpreted as preliminary and exploratory.
METHODS: A quasi-experimental, non-equivalent control group design was conducted with 53 undergraduate public health students (intervention group=25, control group=28). The intervention group participated in a 16-hour active-learning-based professional ethics course; the control group followed the standard curriculum. Moral sensitivity was measured using a newly developed questionnaire with established content and face validity but without confirmed construct validity at three time points. Data were analyzed using linear mixed-effects models with bootstrap sensitivity analyses. Given the design limitations, no causal claims are inferred.
RESULTS: No statistically significant baseline differences were detected between groups (P > 0.05). Following the intervention, the intervention group showed suggestive evidence of higher self-reported moral sensitivity scores compared to controls (group × time interaction: F (2102) = 15.4, P < 0.001). Effect sizes were medium to large (d = 0.71-1.71, with wide confidence intervals). The control group's scores remained largely unchanged over time.
CONCLUSION: This pilot study provides preliminary, hypothesis-generating evidence that an active-learning-based ethics course may be associated with higher scores on a researcher-developed measure of self-reported moral sensitivity in public health students. However, due to methodological limitations (non-randomization, one intact class per condition, small non-diverse sample, unvalidated instrument), no causal claims can be made and the findings should not be interpreted as evidence of improved ethical competence. Future randomized controlled trials with validated instruments are warranted before any curriculum modifications are considered. Given the pilot nature of this work, all results should be interpreted as preliminary and exploratory.